Dietary Patterns and Their Impact on CVD and Cancer: Insights from JACC CardioOncology

The authors also note that implementation science is urgently needed to translate this evidence into sustainable dietary change. Given the limitations of the standard American diet—high in red meat and ultra-processed foods and lacking fiber and phytonutrients, system-wide shifts toward healthier default eating patterns are required.

The Mortality Crisis: Diet as the Leading Risk Driver

CVD and cancer remain the top causes of death in the United States, and recent data show that poor dietary habits have now surpassed traditional risk factors such as smoking and hypertension. This nutritional burden is closely tied to stagnating life expectancy and persistent CVD mortality. Globally, ischemic heart disease continues to be the leading cause of death. While many biological and environmental factors contribute to these conditions, diet consistently emerges as a central determinant.

Methodology: Evidence Synthesis Across Diet, CVD, and Cancer

To address these issues, the authors conducted a comprehensive review of the contemporary literature evaluating the interplay between diet, CVD, and cancer. The review focused on shared dietary risk factors, mechanistic pathways, and outcomes associated with various dietary patterns. Although not a formal systematic review, this this state-of-the-art analysis synthesizes key findings from the past several years to guide future implementation and policy strategies.

Clinical Convergence: Overlapping Risk Factors and Pathways

From a clinical standpoint, CVD and cancer share several nutrition-linked risk factors, including obesity, hypertension, dyslipidemia, and diabetes. These risks are driven by common biological mechanisms such as chronic inflammation, oxidative stress, metabolic dysregulation, and gut microbiome disturbances. Poor diet contributes substantially to cancer incidence and mortality, while cancer survivors themselves have elevated cardiovascular risk, underscoring the importance of dietary intervention in cardio-oncology.

Mechanistic Impact of Animal-Dominant Diets

The authors detail the pathophysiological burden imposed by the standard American diet, which is high in red meat and ultra-processed foods but low in fiber and phytonutrients. Animal-derived foods contain compounds—such as saturated fats, heme iron, and proinflammatory molecules—that drive endothelial dysfunction, metabolic imbalance, and chronic inflammation. In contrast, fiber and many protective nutrients are found exclusively in plant foods, reinforcing the biological rationale for plant-predominant diets.

Guideline Consensus: Support for Plant-Predominant Eating

Major clinical organizations, including the American Heart Association, American College of Cardiology, American Cancer Society, and National Comprehensive Cancer Network, align in recommending plant-forward dietary patterns for prevention. Evidence supports meaningful reductions in incident cardiovascular events with high adherence to plant-centered diets. Interventional studies show improvements in LDL cholesterol, glycemic control, and weight. Plant-based and Mediterranean dietary patterns are also linked to significant reductions in the risk of several cancers, reinforcing their dual preventive role.

Implementation Gap: Moving Evidence into Practice

Despite strong evidence, clinical adoption remains limited. Physicians often lack the time, training, and institutional support needed for comprehensive nutrition counseling. The authors argue that healthcare systems have an ethical responsibility to align hospital food environments with evidence-based dietary guidance. Making plant-based meals the default option is feasible, well accepted, cost-effective, and can serve as a valuable teaching moment for patients. Addressing implementation barriers and shifting structural defaults toward healthier eating patterns will be critical to reversing stalled progress in national mortality trends.

Reference: Hull SC, Mszar R, Ostfeld RJ, Ferrucci LM, Mucci LA, Giovannucci E, Loeb S. Diet and Prevention of Cardiovascular Disease and Cancer: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol. 2025 Oct;7(6):649-667. doi: 10.1016/j.jaccao.2025.07.008. Epub 2025 Aug 29. PMID: 40879583.

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